Active NPI
Susan Lee Mercer, D.O.
- Family Medicine Physician
- Bellevue, WA
National Provider Identifier
1104007343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 00001089
- Practice address
- 15436 SE 20TH PL
Bellevue, WA 98007-6333 - Phone
- (425) 746-0947
- Fax
- (425) 643-9292
- NPI assigned
- Nov 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00001089 | WA | Primary |
Addresses
Primary practice location
15436 SE 20TH PL
Bellevue, WA 98007-6333
Mailing address
15436 SE 20TH PL
Bellevue, WA 98007-6333
Phone (425) 746-0947
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OP00001089 | Other | WA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00001089 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1104007343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15436 SE 20TH PL",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980076333",
"telephone_number": "425-746-0947",
"fax_number": "425-643-9292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15436 SE 20TH PL",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980076333",
"telephone_number": "425-746-0947",
"fax_number": "425-643-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCER",
"first_name": "SUSAN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-15",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "00001089",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "OP00001089",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.